A systematic review of factors associated with the retention of glass fiber posts

This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.

本研究旨在基于对比树脂水门汀（resin cements）粘结的玻璃纤维桩（glass fiber posts, GFPs）粘结强度（bond strength, BS）的体外研究（in vitro studies），明确影响玻璃纤维桩与根管内牙本质之间固位力的相关因素。本研究检索了截至2013年12月收录于PubMed及Scopus数据库的相关文献。从纳入的34项研究中提取了粘结强度值及相关变量，包括患牙类型、牙髓治疗史（endodontic treatment）、桩体预处理方式、粘结剂类型（若存在）、水门汀类型以及水门汀涂布方法。本研究采用线性回归模型评估上述参数对粘结强度的影响。合并所有纳入研究的数据进行分析后发现，存在牙髓治疗史可使粘结强度降低22.7%（P=0.013）。针对常规树脂水门汀，当桩体预处理方式限定为乙醇擦拭、空气喷砂或磷酸处理时，对桩体进行清洁处理后的粘结强度显著高于仅使用硅烷偶联剂而未清洁的组别（P=0.032）。若将水门汀同时涂布于桩体表面与根管内，其粘结固位力显著低于仅涂布于桩体表面（P=0.02）或仅涂布于根管内的组别（P=0.041）；但针对自粘结树脂水门汀（self-adhesive resin cement）开展上述对比时，未观察到组间存在显著差异（P=0.858与P=0.067）。牙髓治疗史、水门汀涂布方式以及桩体预处理方式，是影响树脂水门汀粘结的玻璃纤维桩根管固位力的重要因素，该结论主要适用于常规树脂水门汀粘结体系。与常规树脂水门汀相比，自粘结树脂水门汀对粘结操作的技术敏感性更低。